School of Nursing, Southern Medical University, Guangzhou, China.
Institute of Gerontology, Guangzhou Geriatric Hospital, Guangzhou Medical University, Guangzhou, China.
Psychogeriatrics. 2024 May;24(3):529-541. doi: 10.1111/psyg.13087. Epub 2024 Feb 13.
The purpose of this research was to stratify the level of frailty to examine the risk factors associated with reversible cognitive frailty (RCF) and potentially reversible cognitive frailty (PRCF) in nursing homes to provide a basis for hierarchical management in different stages of frailty.
The study was a cross-sectional study conducted from September to November 2022; 504 people were selected by stratified random sampling after convenience selection from the Home for the Aged Guangzhou. The structured questionnaire survey was conducted through face-to-face interviews using the general data questionnaire, Fried Frailty Phenotype, Montreal Cognitive Assessment Scale.
In total, 452 individuals were included for analysis. A total of 229 cases (50.7%) were PRCF, 70 (15.5%) were RCF. Multivariate logistic regression analysis showed that in pre-frailty, the Geriatric Depression Scale (GDS-15) score (odds ratio (OR) 1.802; 95% CI 1.308-2.483), Instrumental Activities of Daily Living Scale (IADL) score (0.352; 0.135-0.918) and energy (0.288; 0.110-0.755) were influencing factors of RCF. GDS-15 score (1.805; 1.320-2.468), IADL score (0.268; 0.105-0.682), energy (0.377; 0.150-0.947), lack of intellectual activity (6.118; 1.067-35.070), admission time(>3 years) (9.969; 1.893-52.495) and low education (3.465; 1.211-9.912) were influencing factors of PRCF. However, RCF with frailty was associated with the Short-Form Mini-Nutritional Assessment (MNA-SF) score (0.301; 0.123-0.739) and low education time (0 ~ 12 years) (0.021; 0.001-0.826). PRCF with frailty was associated with age (1.327; 1.081-1.629) and weekly exercise time (0.987; 0.979-0.995).
The prevalence of RCF and PRCF was high among pre-frail and frail older adults in nursing homes. Different levels of frailty had different influencing factors for RCF and PRCF. Depression, daily living ability, energy, intellectual activity, admission time, education level, nutrition status, age and exercise time were associated with RCF and PRCF. Hierarchical management and intervention should be implemented for different stages of frailty to prevent or delay the progression of cognitive frailty.
本研究旨在对衰弱程度进行分层，以探讨与养老院可逆性认知衰弱（RCF）和潜在可逆性认知衰弱（PRCF）相关的风险因素，为不同衰弱阶段的分层管理提供依据。
这是一项横断面研究，于 2022 年 9 月至 11 月期间进行，通过便利抽样从广州养老院中选择了 504 人进行分层随机抽样。通过使用一般数据问卷、Fried 衰弱表型和蒙特利尔认知评估量表进行面对面访谈进行结构化问卷调查。
共有 452 人纳入分析。共有 229 例（50.7%）为 PRCF，70 例（15.5%）为 RCF。多变量逻辑回归分析表明，在衰弱前期，老年抑郁量表（GDS-15）评分（比值比（OR）1.802；95%置信区间（CI）1.308-2.483）、工具性日常生活活动量表（IADL）评分（0.352；0.135-0.918）和能量（0.288；0.110-0.755）是 RCF 的影响因素。GDS-15 评分（1.805；1.320-2.468）、IADL 评分（0.268；0.105-0.682）、能量（0.377；0.150-0.947）、缺乏智力活动（6.118；1.067-35.070）、入住时间（>3 年）（9.969；1.893-52.495）和低教育水平（3.465；1.211-9.912）是 PRCF 的影响因素。然而，RCF 伴衰弱与简易营养评估量表（MNA-SF）评分（0.301；0.123-0.739）和低教育年限（0~12 年）（0.021；0.001-0.826）有关。PRCF 伴衰弱与年龄（1.327；1.081-1.629）和每周运动时间（0.987；0.979-0.995）有关。
养老院衰弱前期和衰弱期老年人的 RCF 和 PRCF 患病率较高。不同程度的衰弱对 RCF 和 PRCF 有不同的影响因素。抑郁、日常生活能力、能量、智力活动、入住时间、教育水平、营养状况、年龄和运动时间与 RCF 和 PRCF 有关。应针对不同衰弱阶段进行分层管理和干预，以预防或延缓认知衰弱的进展。
